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1.
Retin Cases Brief Rep ; 11(4): 298-301, 2017.
Article in English | MEDLINE | ID: mdl-27472515

ABSTRACT

PURPOSE: To report a case of tarantula hair-induced panuveitis treated with sustained-release intravitreal dexamethasone implant and followed by sequential spectral domain optical coherence tomography imaging. METHODS: Findings on clinical examination, anterior segment optical coherence tomography, corneal in vivo confocal microscopy, color fundus photos, fluorescein angiography, and retinal spectral domain optical coherence tomography are presented. Sequential optical coherence tomography images demonstrated the course of the chorioretinal lesions before and after sustained-release intravitreal dexamethasone implant. RESULTS: A 19-year-old female presented with localized temporal episcleritis and scleritis that incompletely resolved despite multiple courses of topical and oral corticosteroids. She subsequently developed focal vitritis and chorioretinitis, and was found to have tarantula hair-induced panuveitis. Anterior segment optical coherence tomography and in vivo confocal microscopy confirmed the presence of tarantula hairs embedded in the anterior corneal stroma. There was only transient improvement with posterior sub-Tenon's Kenalog injection. After treatment with sustained-release intravitreal dexamethasone implant, her symptoms improved and the chorioretinal lesions became inactive. Sequential spectral domain optical coherence tomography images revealed hyperreflective inner retina lesions that progressed to involve the outer retina, and then flattened to near resolution after therapy. CONCLUSION: This is the first case showing positive clinical outcomes supported by sequential retinal spectral domain optical coherence tomography using a sustained-release intravitreal dexamethasone implant to treat ophthalmia nodosa-induced by tarantula hairs.


Subject(s)
Anti-Inflammatory Agents/administration & dosage , Dexamethasone/administration & dosage , Hair , Panuveitis/drug therapy , Spiders , Animals , Delayed-Action Preparations/therapeutic use , Drug Implants , Female , Humans , Panuveitis/ethnology , Young Adult
2.
Br J Ophthalmol ; 97(5): 644-7, 2013 May.
Article in English | MEDLINE | ID: mdl-23449344

ABSTRACT

AIM: To describe the increasing incidence of multifocal outer retinal and inner choroidal inflammation as a marker for intraocular tuberculosis in the UK, a non-endemic area. PATIENTS AND METHODS: Retrospective case series. RESULTS: 14 patients presented with serpiginous-like choroiditis over 10 years (seven within the last 2 years). Seven of 14 patients showed evidence of exposure to tuberculosis and received antituberculous treatment. 17 of 23 eyes showed stable or improved visual acuity. All with decreased acuity had direct macular involvement at presentation. CONCLUSIONS: Multifocal outer retinal and inner choroidal inflammation is a marker for intraocular tuberculosis of increasing importance, even in a non-endemic area. Originally described as 'serpiginous-like choroiditis', the lesions are multifocal, irregular in shape, very numerous, widespread, often asymmetrical and often demonstrating both active and resolved lesions simultaneously. Active lesions show contiguous extension. We recommend that every patient with SLC should undergo testing for previous exposure to tuberculosis, and undergo antituberculous treatment if lesions are progressive and sight-threatening.


Subject(s)
Choroiditis/diagnosis , Panuveitis/diagnosis , Tuberculosis, Ocular/diagnosis , Adolescent , Adult , Antitubercular Agents/therapeutic use , Child , Choroiditis/drug therapy , Choroiditis/ethnology , Drug Therapy, Combination , Emigrants and Immigrants , Ethnicity , Female , Humans , Incidence , Interferon-gamma Release Tests , Male , Middle Aged , Mycobacterium tuberculosis/isolation & purification , Panuveitis/drug therapy , Panuveitis/ethnology , Retrospective Studies , Tuberculin Test , Tuberculosis, Ocular/drug therapy , Tuberculosis, Ocular/ethnology , United Kingdom/epidemiology , Visual Acuity/physiology , Young Adult
3.
Clin Exp Rheumatol ; 28(4 Suppl 60): S20-6, 2010.
Article in English | MEDLINE | ID: mdl-20868566

ABSTRACT

OBJECTIVES: To analyse the clinical manifestations and severity of Behçet's disease (BD) in Korea according to geographic region of residence, and to identify risk factors associated with clinical severity. METHODS: We enrolled 246 BD patients (88 males) who fulfilled the criteria of the International Study Group for BD. These patients were assigned into two groups: a Western group comprising 127 residents in west regions and an Eastern group comprising 119 residents of the SoBaek Mountains situated in the center of Korea. Clinical severity was assessed using a severity scoring index of BD. RESULTS: BD patients from the Western group had a greater prevalence of typical skin lesions, deep vein thrombosis, gastrointestinal bleeding, posterior/ panuveitis, and retinal vasculitis than did the Eastern group (p<0.001, p=0.009, p=0.032, and p=0.007, respectively). The Western group also had higher severity scores than did the Eastern group (5.88±2.5 for the Western group vs. 4.94±2.6 for the Eastern group, p=0.004). Male BD patients had higher severity scores than did female patients (6.14±2.8 vs. 5.03±2.4, p=0.001). The disease duration of BD in the Western group showed a significant association with total severity scores (r=0231, p=0.009), but this was not observed for the Eastern group. CONCLUSIONS: We found distinct differences in the clinical manifestations as well as severity of BD according to geographic region in Korean BD patients. Males, particularly those from the Western region of Korea, had significantly higher severity scores than did females.


Subject(s)
Behcet Syndrome/ethnology , Behcet Syndrome/epidemiology , Severity of Illness Index , Academic Medical Centers , Adult , Female , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/ethnology , Humans , Korea/epidemiology , Male , Middle Aged , Panuveitis/epidemiology , Panuveitis/ethnology , Prevalence , Retinal Vasculitis/epidemiology , Retinal Vasculitis/ethnology , Risk Factors , Sex Characteristics , Skin Ulcer/epidemiology , Skin Ulcer/ethnology , Venous Thrombosis/epidemiology , Venous Thrombosis/ethnology
4.
Acta Ophthalmol ; 86(5): 576-8, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18039349

ABSTRACT

PURPOSE: To report a case of Vogt-Koyanagi-Harada syndrome (VKH) in an Inuit. METHODS: We carried out a medical evaluation and human leucocyte antigen (HLA) genotyping. RESULTS: A 36-year-old male Inuit developed severely decreased vision, intense headache and vertigo over a 3-week period. Ocular examination revealed panuveitis with bilateral serous retinal detachment and optic nerve head oedema. There was no history of ocular trauma or evidence suggestive of other disease entities. The patient responded well to high-dose systemic prednisolone. Vitiligo presented late in the course. CONCLUSIONS: This case report describes the first published case of VKH in a patient of Inuit ancestry. The patient was homozygous for HLA-DR4, a genotype previously associated with VKH.


Subject(s)
Inuit/ethnology , Uveomeningoencephalitic Syndrome/ethnology , Adult , Fundus Oculi , Genotype , Glucocorticoids/therapeutic use , Greenland/epidemiology , HLA Antigens/genetics , Humans , Male , Panuveitis/diagnosis , Panuveitis/drug therapy , Panuveitis/ethnology , Prednisolone/therapeutic use , Uveomeningoencephalitic Syndrome/diagnosis , Uveomeningoencephalitic Syndrome/drug therapy , Visual Acuity
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